Utilization Management Director leads and directs the utilization review staff and function for a healthcare facility. Determines policies and procedures that incorporate best practices and ensure effective utilization reviews. Being a Utilization Management Director manages and monitors both concurrent reviews to ensure that the patient is getting the right care in a timely and cost-effective way and retrospective reviews after treatment has been completed. Provides analysis and reports of significant utilization trends, patterns, and impacts to resources. Additionally, Utilization Management Director consults with physicians and other professionals to develop improved utilization of effective and appropriate services. Requires a master's degree. Typically reports to top management. Typically requires Registered Nurse(RN). The Utilization Management Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Utilization Management Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)
Assists the hospital health care team in maintaining quality, efficient and patient-centered care. Serves as a resource to physicians, conducts admission and concurrent reviews, identifies patients who do not meet criteria, takes action to ensure the patient is placed in the most appropriate alternative level of care, and determines the correct admission status and level of care for those patients who meet hospital admission criteria (ambulatory surgery, observation and inpatient).
Minimum Education and Experience Requirements:
Licensure/Certification/Registration:
Minimum Pay Rate - Hourly: $32.42
Midpoint Pay Rate - Hourly: $44.28
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UF Health Shands Hospital is committed to diversity as a competitive advantage in attracting top talent from across the nation and around the world. We believe in sharing knowledge, learning from one another, valuing different opinions, and celebrating the things that make each one of us unique in our own right. UF Health Shands Hospital is an equal opportunity employer and drug-free workplace. Equal Opportunity Employer M/F/D/V
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